This pain is not age-related! Why won't anyone listen?

Imagine being told the only solution for your pain is to give up all the things you love? That’s what happened in February 2016. I had fallen while running and landed hard on my outstretched arm. I would have been better off landing on my face like I did at the Boston Marathon in 2011 because for the next four years, that painful injury put the kibosh on almost everything that brought me joy. In my three decades as a family doctor in the Comox Valley, I have delivered more than 1,500 babies. But my on-going shoulder issues meant I had to stop this exceptionally rewarding part of my practice after a second failed shoulder repair in 2017. It also put a damper on my other passions: skiing and especially running. I have run more marathons than any other Canadian woman: 422 marathons and 39 ultra marathons, including 25 Boston marathons. I’m part of a prestigious group of athletes who have completed marathons on all seven continents, and an Antarctica run consisted of 426 laps on the deck of a ship! My overall favourite was the Inca Trail Marathon in Peru. In my search for relief, I saw 10 different specialists, went for treatments, and had three operations, including a reverse shoulder replacement in 2018. But the pain didn’t go away. In fact, it got worse. Incredibly, even with my knowledge as a physician, my insistence that something was wrong was dismissed by almost everyone. (“Go home and talk to your GP about your chronic pain.”) It’s an unfortunate and ageist fact that when you’re a runner and you complain about pain, you’re told it’s your age or that you are too active. I was an elite athlete. I knew my pain wasn’t from running. You don’t run with your shoulder. Read: Are anti-inflammatories and steroids causing chronic pain? Frustrated and at the end of my patience, I reached out to two surgeon classmates from medical school at Queen’s University after our 40th class reunion. With their intervention I began exploring options in Alberta, Ontario, Colorado and even the Mayo Clinic in Minnesota, where I have a marathon physio friend who works with Dr. Sperling. (I grew up in Vancouver but chose Queen’s over the University of British Columbia in 1974—one of my best life decisions). I was so desperate, I would have gone anywhere, but then the pandemic began, travel was out, and I needed to find a solution close to home. After nine long months pleading for an appropriate referral (re abnormal CT scan), I got an appointment with Dr. Mark Cresswell, an interventional radiologist at St. Paul’s Hospital and, by definition, a problem solver. Cresswell looked at the images of my shoulder with dynamic ultrasound—and he listened to my description of the pain. Mark was the first person who believed me when I said my pain was not caused by running—or age. The ah-ha moment He immediately suspected that one of the four screws used in the replacement had likely been mispositioned, causing it to irritate the adjacent supraspinatus muscle. Shoulder replacement is a very technical procedure that requires exacting precision. Misalignments are extremely rare, (1/1255, according to a Swedish review article), but when they happen, they can lead to chronic pain. It was an ah-ha moment: a misplaced screw would explain why my pain worsened almost immediately after reverse shoulder surgery. Cresswell referred me to his colleague Dr. Jeff Pike, a renowned orthopedic surgeon at St. Paul’s Hospital. My classmates gave Pike a rousing endorsement and I learned he had trained with Canada’s ‘shoulder guru.’ Dr. Pike removed the misaligned screw in a minor revision procedure two years after the original RSA with a slight delay due to COVID operating room cancellations. Read: I’m fed up, and I can’t take it anymore. The happy ending Sure enough, within 48 hours of my surgery with Dr. Pike, the pain was gone and I knew my shoulder was fixed. Previously I had ongoing problems with sleeping, typing, driving and cycling, as well as running and skiing. Basically, I could not use my dominant right arm properly for four plus years. St. Paul’s is truly amazing. I was so impressed with my experience at there that I took the $100,000 I had saved to travel to the Mayo Clinic and donated it to St. Paul’s Foundation—earmarked for “upper extremity innovation” at the new St. Paul’s Hospital. (Coincidentally, Dr. Pike is the physician lead of clinical planning for the new St. Paul’s Hospital redevelopment project.) In a world-class facility, with skilled and compassionate caregivers like Dr. Cresswell and Dr. Pike—and the support of grateful patients—many more people could get their lives back so they can ski, and run and still work as a family doctor. (No more trail races or powder skiing holidays though!) I thought I was going to have to live in pain for the rest of my life. I’m so grateful and so happy to give back. I am also very grateful to Dr. Sheriff, rheumatologist and Dr. Davidson and Caillier, physiatrists who could ‘think outside the box.’ I hope that my story will help other specialists to LISTEN to their patients in the future (and not presume that they are crazy!) This story is based on content originally written and published by St. Paul's Foundation. Read: How psychological aspects of healing are important for hospital design.

This pain is not age-related! Why won't anyone listen?

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